So many of us have been here: You go to the bathroom but while you’re peeing, you recognize the telltale burning, painful feeling that means a urinary tract infection (UTI) is brewing. UTIs are a prevalent health issue among people of all ages, affecting about 10% of all women annually Older adults have UTIs at higher rates (30% of women over 85 annually) and tend to have more risk factors due to changes in immune function, urinary retention, and having had UTIs in the past. Chronic health conditions and the use of catheters can also play a role.
UTIs can also look a little different in older adults; in addition to the frequent urge to pee and burning sensation, one of the most concerning and frequently overlooked symptoms in this age group is confusion or delirium.
Why Can UTIs Cause Confusion in Older Adults?
In older adults, UTIs can trigger mental changes due to the body’s inflammatory response, which affects brain function. Says Attn: Grace Medical Director, Dr. Barbara Frank, “As we age, our brain becomes more sensitive to changes in our homeostasis (our normal baseline in the body) and when you have any infection, with or without fevers, you could be prone to having inflammation in the brain.” Delirium (sudden disorientation or confusion) can occur even before any physical symptoms appear.
Additionally, older adults may have reduced pain perception or cognitive impairment, making it harder to recognize the usual UTI signs like burning or cloudy urine. As a result, a UTI may go unnoticed until confusion becomes apparent.
What Does UTI-Induced Delirium Look Like?
If a UTI is affecting brain function, you might notice::
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Sudden disorientation or inability to recognize familiar people or places
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Inability to concentrate or follow conversations
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Agitation or unusual irritability
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Hallucinations or delusional thinking
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Increased drowsiness or lethargy
Dr. Frank adds, “Beyond restlessness, it could also be as bad as slurred speech and delusions.” These symptoms can be mistaken for dementia or a neurological condition, so it’s crucial to consider a UTI as a possible cause.
Why Early UTI Diagnosis is Critical
It’s so important that older adults with a UTI are diagnosed quickly to prevent complications. A simple urine test can confirm the infection. Once diagnosed, antibiotics are usually given to clear the infection. Notes Dr. Frank, “In adults 60+ with a UTI, we want to be aware of complicating factors like antibiotic-resistant bacteria. It is important that if you get a UTI, you leave a urine culture to make sure we are treating you with the proper antibiotics.”
In cases of severe confusion or delirium, or a UTI that’s progressed, a person could be hospitalized to get the care they need. Once treated, the infection is addressed and cognitive symptoms usually rapidly improve.
How to Prevent UTIs in Older Adults
Because UTIs can be severe and show up in paradoxical ways, prevention is key. Here are some simple strategies that older adults can use to avoid UTIs:
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Stay hydrated: drinking fluids helps to flush out bacteria
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Keep the genital area dry
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Use Skin-Safe Products: Attn: Grace pads, liners and briefs are moisture-wicking and skin-safe
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Fully empty your bladder: avoid urine retention, which can encourage bacterial growth
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Manage chronic health conditions. Conditions like diabetes can increase UTI risk
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Consult your doctor: if something seems wrong, speak to your doctor for further guidance
Final Thoughts
When an older adult is suddenly irritable, confused, or agitated, always consider whether an infection—like a UTI—could be at play. If it is, swift diagnosis of a UTI can swiftly address the underlying cause and get them back to full health quickly.
Disclaimer: This content is for informational purposes only, even if and regardless of whether it features the advice of physicians and medical practitioners. This content is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and should never be relied upon for specific medical advice.